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AFib rising among younger people: US study Atrial fibrillation (AFib), an abnormal heart rhythm that affects the heart’s upper chambers and can increase the risk of stroke and heart failure, is not restricted to older people, say scientists, who suggest it is increasingly affecting people under 65 years. In their recent study, published in Circulation: Arrhythmia and Electrophysiology, they highlighted the need to manage risk factors and AFib among younger individuals. They said while the condition is more likely to occur in adults aged between 70 and 80 years, it appears to be affecting an increasing number of younger people The researchers included 67 221 adults with AFib as part of their study. Of this number, 17 were under 65 years. The researchers looked at all-cause mortality, hospitalisations and other cardiac interventions that participants received: the average follow-up time was about five years. During the follow-up, 2 084 participants died. The researchers found that those under 65 years of age had notable additional cardiovascular risk factors. For example, 16% were current smokers, 55% had high blood pressure, 20% had heart failure, 21% had diabetes, and more than 20% had significant obesity. Additionally, more than half of the participants under 65 years were receiving anticoagulants. Overall, researchers found that those under 65 years with AFib had an increased mortality risk compared with an internal control population, and an increased risk for hospitalisation from heart attack, heart failure and all-cause stroke. Study author Aditya Bhonsale, MD, MHS, assistant professor of medicine with the Division of Cardiac Electrophysiology at the University of Pittsburgh Medical Centre Heart and Vascular Institute, told MedicalNewsToday: ‘Our large real-world cohort demonstrates that AFib patients under 65 have substantial co-morbidity burden, particularly obesity, heart failure and hypertension, with considerable long-term mortality rates (6.7% < 50 years; 13% 50–65 years). They are also at a significantly increased risk of hospitalisation for heart failure, stroke and myocardial infarction compared with those without AFib. ‘Our study suggests that management of AFib patients under 65 must be in the context of their individual cardiovascular risk factor burden, and lifestyle modification with appropriate focus on non-cardiac risk factors.’ This research does have limitations. First, it cannot establish cause, and second, 95% of the participants were white, so researchers can include more diverse cohorts in the future. In the population under 50 years, 73% of participants were male, so more research in the future could potentially focus on females with AFib. The researchers acknowledge that they did not measure quality-of-life metrics or ascertain the cause of death among participants. They also lacked information on alcohol consumption, which could have affected existing relationships. ‘Research on impact of risk-factor modification and trajectories of risk factors in younger patients needs [to be] done in the future,’ noted Bhonsale. ‘This will allow for optimal management and mitigate adverse outcomes.’ Source: MedicalBrief 2024
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